Current situation of allergy education in Mexico and other parts of Latin America.

Allergic diseases are one of the most frequent chronic diseases in the world. It has been established that there is a worldwide epidemic of allergic diseases; therefore, the treatment of allergies should be acknowledged as a worldwide priority and the specialty of allergy should be considered an important field in medicine. Due to the fact that allergic diseases involve many organs, and Allergy and Clinical Immunology is one of the specialties in which physicians may be trained to treat patients of all ages, the subject in medical schools is not always taught as an individual specialty but often as part of another subject such as internal medicine or pediatrics. Certified allergists are an important contribution to health systems, providing the necessary care for patients who have allergic diseases. Undergraduate programs in many universities do not include allergy as a subject, contributing to a lack of knowledge regarding the correct management of allergic diseases. World Health Organization (WHO) recommends 1 allergist per 50,000 people; however, there is an uneven distribution of allergy and clinical immunology specialists. Most practitioners are localized mainly in larger cities and state capitals, while in other regions, specialists are still greatly needed. Support and training systems are required for allergy and clinical immunology specialists to promote continuing education and keep their clinical competence up to date, which will lead to better care for their patients. Increased exposure to the concepts of allergy and clinical immunology diagnosis and treatment in undergraduate education may also potentially lead to an increase in interest in the field of allergy and clinical immunology among physicians in training. This review will approach allergy education in Mexico and other parts of Latin America.

[Related systemic reactions to allergen immunotherapy in Monterrey, Mexico]. / Reacciones sistémicas relacionadas a la inmunoterapia con alergenos en Monterrey, México.

BACKGROUND: Patients who receive allergen immunotherapy (IT) have a potential risk of systemic reactions, however such reactions are rare when IT administered properly. The frequency of systemic reactions (SR) due to conventional IT is less than 1%. OBJECTIVE: To determine the frequency of secondary SR to allergen IT, and to identify the possible factors involved in developing them. METHODS: A retrospective descriptive study that included 2.319 patients who received 14.600 allergen immunotherapy injections during the period from May 1, 2001 to April 30, 2002. RESULTS: Twelve patients had a SR (age 7 - 40 years), all of which occurred within the first 30 minutes after the IT. These were more frequent during the dose - increase phase (58%). The frequency of (RS) in relation to the number of injections was 1:1216, and regarding to the number of patients, 1:193. The clinical manifestations included bronchospasm 83%, urticaria 67%, gastrointestinal symptoms and hypotension 8.3%. The 58% had anaphylaxis and pulmonary or dermatological symptoms only in 33% and 8.3% respectively. The possible factors involved in the onset of SR were: sensitivity identified by large skin reactions in skin test (PC) 83%, uncontrolled asthma 50%, application of allergens IT during high pollination season 42%, inadequate immunotherapy scheme monitoring 17%. CONCLUSIONS: The frequency of SR in this group of patients was low as that reported in other publications.

[Epidemiological characteristics of patients with food allergy assisted at Regional Center of Allergies and Clinical Immunology of Monterrey]. / Características epidemiológicas de pacientes con alergia a alimentos atendidos en el Centro Regional de alergias e Inmunologia Clínica de Monterrey.

BACKGROUND: Food allergy is an abnormal immunologic response to food allergens. Prevalence varies between 2% and 8%, although it could vary according to age and ethnicity. Clinical manifestations are diverse among systems. There is few information about this issue. OBJECTIVE: To know epidemiologic features in patients with food allergy attended at Monterrey University Hospital. PATIENTS AND METHOD: An observational, transversal and retrospective study was done, identifying 60 patients with food allergy diagnosis attended in our service from June 1, 2007 to December 31, 2008. Epidemiologic and clinical data were registered. Data was processed with statistical program SPSS v16.0 for windows with descriptive statistic. RESULTS: The frequency of food allergy reported in first time medical consultation was 2.67%, 51% of the patients were under 5 years of age. Most frequent foods were: dairy products, egg, fish, shrimp, beans, soy, chili, mango, cacao, and strawberry. Main symptoms were cutaneous in 58% of the patients, followed by gastrointestinal and respiratory. Most common concomitant diseases were: urticarial angioedema (38%), allergic rhinitis (20%), atopic dermatitis (15%), and asthma (6.6%). Average time for diagnosis was 1.45 years. CONCLUSIONS: Most common foods with positive Prick test results were dairy products, egg and fish. Despite the variability of the clinical manifestations, cutaneous and gastrointestinal manifestations are the most frequent; however, the diagnosis depends on the suspicion as well.